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Frailty in Older Adults with Cancer pp 189–202Cite as

Multidisciplinary Onco-Geriatric Care Models

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Abstract

The management of older cancer patients with frailty is complex, and as such it requires the collaboration of various disciplines and healthcare providers. However, despite the existence of evidence demonstrating that multidisciplinary care can lead to improved outcomes among older patients, there are still many barriers to their implementation across various clinical settings. Multidisciplinary geriatrics teams have been utilized in other areas of medicine, such as orthopaedics, for decades, and can have beneficial effects on relevant outcomes, such as the amelioration of functional decline. This chapter reviews the existing models of care in geriatric oncology and provides an overview of the advantages and disadvantages of each one of them, including the challenges and barriers to the implementation of these services. Finally, an overview of the utilization of geriatric oncology assessments and interventions by a multidisciplinary team across various settings is provided in this chapter, along with recommendations on how to adapt models of care in accordance with existing resources.

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References

  1. Balducci L, Extermann M. Management of the frail person with advanced cancer. Crit Rev Oncol Hematol. 2000;33(2):143–8.

    Article  CAS  PubMed  Google Scholar 

  2. Ethun CG, Bilen MA, Jani AB, Maithel SK, Ogan K, Master VA. Frailty and cancer: implications for oncology surgery, medical oncology, and radiation oncology. CA Cancer J Clin. 2017;67(5):362–77.

    Article  PubMed  Google Scholar 

  3. Dyer CB, Hyer K, Feldt KS, Lindemann DA, Busby-Whitehead J, Greenberg S, et al. Frail older patient care by interdisciplinary teams: a primer for generalists. Gerontol Geriatr Educ. 2003;24(2):51–62.

    Article  PubMed  Google Scholar 

  4. Sabharwal S, Wilson H. Orthogeriatrics in the management of frail older patients with a fragility fracture. Osteoporos Int. 2015;26(10):2387–99.

    Article  CAS  PubMed  Google Scholar 

  5. Riemen AH, Hutchison JD. The multidisciplinary management of hip fractures in older patients. Orthop Trauma. 2016;30(2):117–22.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Aw D, Sahota O. Orthogeriatrics moving forward. Age Ageing. 2014;43(3):301–5.

    Article  PubMed  Google Scholar 

  7. Crooks EA, Geldmacher DS. Interdisciplinary approaches to Alzheimer’s disease management. Clin Geriatr Med. 2004;20(1):121–39.

    Article  PubMed  Google Scholar 

  8. Arnett DK, Goodman RA, Halperin JL, Anderson JL, Parekh AK, Zoghbi WA. AHA/ACC/HHS strategies to enhance application of clinical practice guidelines in patients with cardiovascular disease and comorbid conditions: from the American Heart Association, American College of Cardiology, and U.S. Department of Health and Human Services. J Am Coll Cardiol. 2014;64(17):1851–6.

    Article  PubMed  Google Scholar 

  9. Forman DE, Rich MW, Alexander KP, Zieman S, Maurer MS, Najjar SS, et al. Cardiac care for older adults. Time for a new paradigm. J Am Coll Cardiol. 2011;57(18):1801–10.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Jung SM, Hong YS, Kim TW, Park JH, Kim JH, Park SH, et al. Impact of a multidisciplinary team approach for managing advanced and recurrent colorectal cancer. World J Surg. 2018;42(7):2227–33.

    Article  PubMed  Google Scholar 

  11. Snelgrove RC, Subendran J, Jhaveri K, Thipphavong S, Cummings B, Brierley J, et al. Effect of multidisciplinary cancer conference on treatment plan for patients with primary rectal cancer. Dis Colon Rectum. 2015;58(7):653–8.

    Article  PubMed  Google Scholar 

  12. Gomes FM, Santos KTDO, Silva SME, Pinho CPS, Silva A. Fragilidad en ancianos oncológicos en tratamiento con quimioterapia. Rev Chil Nutr. 2019;46:384–91.

    Article  Google Scholar 

  13. Bruijnen CP, van Harten-Krouwel DG, Koldenhof JJ, Emmelot-Vonk MH, Witteveen PO. Predictive value of each geriatric assessment domain for older patients with cancer: a systematic review. J Geriatr Oncol. 2019 Nov;10(6):859–73.

    Article  PubMed  Google Scholar 

  14. Caillet P, Canoui-Poitrine F, Vouriot J, Berle M, Reinald N, Krypciak S, et al. Comprehensive geriatric assessment in the decision-making process in elderly patients with cancer: ELCAPA study. J Clin Oncol. 2011;29(27):3636–42.

    Article  PubMed  Google Scholar 

  15. Hamaker ME, Vos AG, Smorenburg CH, de Rooij SE, van Munster BC. The value of geriatric assessments in predicting treatment tolerance and all-cause mortality in older patients with cancer. Oncologist. 2012;17(11):1439–49.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kristjansson SR, Rønning B, Hurria A, Skovlund E, Jordhøy MS, Nesbakken A, et al. A comparison of two pre-operative frailty measures in older surgical cancer patients. J Geriatr Oncol. 2012;3(1):1–7.

    Article  Google Scholar 

  17. Balducci L, Extermann M. Management of cancer in the older person: a practical approach. Oncologist. 2000;5(3):224–37.

    Article  CAS  PubMed  Google Scholar 

  18. Ruiz M, Reske T, Cefalu C, Estrada J. Management of elderly and frail elderly cancer patients: the importance of comprehensive geriatrics assessment and the need for guidelines. Am J Med Sci. 2013;346(1):66–9.

    Article  PubMed  Google Scholar 

  19. Magnuson A, Dale W, Mohile S. Models of care in geriatric oncology. Curr Geriatr Rep. 2014;3(3):182–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Korc-Grodzicki B, Tew W, Hurria A, et al. Development of a Geriatric Service in a Cancer Center: lessons learned. J Oncol Pract. 2017;13(2):107–12.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Verduzco-Aguirre HC, Navarrete-Reyes AP, Chavarri-Guerra Y, Ávila-Funes JA, Soto-Perez-de-Celis E. The effect of a geriatric oncology clinic on treatment decisions in Mexican older adults with cancer. J Am Geriatr Soc. 2019;67(5):992–7.

    Article  PubMed  Google Scholar 

  22. Terret C, Zulian GB, Naiem A, Albrand G. Multidisciplinary approach to the geriatric oncology patient. J Clin Oncol. 2007;25(14):1876–81.

    Article  PubMed  Google Scholar 

  23. Kenis C, Heeren P, Decoster L, Van Puyvelde K, Conings G, Cornelis F, et al. A Belgian survey on geriatric assessment in oncology focusing on large-scale implementation and related barriers and facilitators. J Nutr Health Aging. 2016;20(1):60–70.

    Article  CAS  PubMed  Google Scholar 

  24. Monfardini S, Balducci L. A comprehensive geriatric assessment (CGA) is necessary for the study and the management of cancer in the elderly. Eur J Cancer. 1999;35(13):1771–2.

    Article  CAS  PubMed  Google Scholar 

  25. Soto-Perez-de-Celis E, de Glas NA, Hsu T, Kanesvaran R, Steer C, Navarrete-Reyes AP, et al. Global geriatric oncology: achievements and challenges. J Geriatr Oncol. 2017;8(5):374–86.

    Article  PubMed  Google Scholar 

  26. Williams GR, Deal AM, Jolly TA, Alston SM, Gordon BB, Dixon SA, et al. Feasibility of geriatric assessment in community oncology clinics. J Geriatr Oncol. 2014;5(3):245–51.

    Article  PubMed  Google Scholar 

  27. Decoster L, Van Puyvelde K, Mohile S, Wedding U, Basso U, Colloca G, et al. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations†. Ann Oncol. 2015;26(2):288–300.

    Article  CAS  PubMed  Google Scholar 

  28. Kenis C, Decoster L, Van Puyvelde K, De Grève J, Conings G, Milisen K, et al. Performance of two geriatric screening tools in older patients with cancer. J Clin Oncol. 2014;32(1):19–26.

    Article  PubMed  Google Scholar 

  29. Bellera CA, Rainfray M, Mathoulin-Pélissier S, Mertens C, Delva F, Fonck M, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol. 2012;23(8):2166–72.

    Article  CAS  PubMed  Google Scholar 

  30. Soubeyran P, Bellera C, Goyard J, Heitz D, Curé H, Rousselot H, et al. Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study. PLoS One. 2014;9(12):e115060.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Min LC, Elliott MN, Wenger NS, Saliba D. Higher vulnerable elders survey scores predict death and functional decline in vulnerable older people. J Am Geriatr Soc. 2006;54(3):507–11.

    Article  PubMed  Google Scholar 

  32. Mohile SG, Bylow K, Dale W, Dignam J, Martin K, Petrylak DP, et al. A pilot study of the vulnerable elders survey-13 compared with the comprehensive geriatric assessment for identifying disability in older patients with prostate cancer who receive androgen ablation. Cancer. 2007;109(4):802–10.

    Article  PubMed  Google Scholar 

  33. Meldon SW, Mion LC, Palmer RM, Drew BL, Connor JT, Lewicki LJ, et al. A brief risk-stratification tool to predict repeat emergency department visits and hospitalizations in older patients discharged from the emergency department. Acad Emerg Med. 2003;10(3):224–32.

    Article  PubMed  Google Scholar 

  34. Rodin MB, Mohile SG. A practical approach to geriatric assessment in oncology. J Clin Oncol. 2007;25(14):1936–44.

    Article  PubMed  Google Scholar 

  35. Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen ML, Extermann M, et al. International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol. 2014;32(24):2595–603.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Anderson BO, Shyyan R, Eniu A, Smith RA, Yip CH, Bese NS, et al. Breast cancer in limited-resource countries: an overview of the breast health global initiative 2005 guidelines. Breast J. 2006;12(Suppl 1):S3–15.

    Article  PubMed  Google Scholar 

  37. Anderson BO, Yip CH, Smith RA, Shyyan R, Sener SF, Eniu A, et al. Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007. Cancer. 2008;113(8 Suppl):2221–43.

    Article  PubMed  Google Scholar 

  38. Anderson BO, Cazap E, El Saghir NS, Yip CH, Khaled HM, Otero IV, et al. Optimisation of breast cancer management in low-resource and middle-resource countries: executive summary of the breast health global initiative consensus, 2010. Lancet Oncol. 2011;12(4):387–98.

    Article  PubMed  Google Scholar 

  39. Loh KP, Soto-Perez-de-Celis E, Hsu T, de Glas NA, Battisti NML, Baldini C, et al. What every oncologist should know about geriatric assessment for older patients with cancer: Young International Society of Geriatric Oncology Position Paper. J Oncol Pract. 2018;14(2):85–94.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Mohile SG, Mohamed MR, Culakova E, Xu H, Loh KP, Magnuson A, et al. A geriatric assessment (GA) intervention to reduce treatment toxicity in older patients with advanced cancer: a University of Rochester Cancer Center NCI community oncology research program cluster randomized clinical trial (CRCT). J Clin Oncol. 2020;38(15 suppl):12009.

    Article  Google Scholar 

  41. Li D, Sun C-L, Kim H, Chung V, Koczywas M, Fakih M, et al. Geriatric assessment-driven intervention (GAIN) on chemotherapy toxicity in older adults with cancer: a randomized controlled trial. J Clin Oncol. 2020;38(15 suppl):12010.

    Article  Google Scholar 

  42. Soo W-K, King M, Pope A, Parente P, Darzins P, Davis ID. Integrated geriatric assessment and treatment (INTEGERATE) in older people with cancer planned for systemic anticancer therapy. J Clin Oncol. 2020;38(15 suppl):12011.

    Article  Google Scholar 

  43. Soto-Perez-de-Celis E, Aapro M, Muss H. ASCO 2020: the geriatric assessment comes of age. Oncologist. 2020;25(11):909–12.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Carolina Gómez-Moreno

  2. University Hospital Fundacion Jimenez Diaz, Madrid, Spain

    Raúl Córdoba

  3. Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain

    Javier Martínez-Peromingo

  4. Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    José Alberto Avila-Funes & Enrique Soto-Perez-de-Celis

Authors
  1. Carolina Gómez-Moreno
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  2. Raúl Córdoba
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  3. Javier Martínez-Peromingo
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  4. José Alberto Avila-Funes
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  5. Enrique Soto-Perez-de-Celis
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Corresponding author

Correspondence to Enrique Soto-Perez-de-Celis .

Editor information

Editors and Affiliations

  1. Medical Oncology Department, The Christie NHS Foundation Trust, Manchester, UK

    Fabio Gomes

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Gómez-Moreno, C., Córdoba, R., Martínez-Peromingo, J., Avila-Funes, J.A., Soto-Perez-de-Celis, E. (2022). Multidisciplinary Onco-Geriatric Care Models. In: Gomes, F. (eds) Frailty in Older Adults with Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-89162-6_11

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  • DOI: https://doi.org/10.1007/978-3-030-89162-6_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-89161-9

  • Online ISBN: 978-3-030-89162-6

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